Contrary to Kaiser
recommendations for Hospice
patients with difficulty
breathing on how to take Morphine -
DO NOT DO IT WITHOUT ABSOLUTE ASSURANCE FROM A
PHYSICIAN
THAT IT
IS NEEDED! Kaiser Hospice
statements and a medical doctor's opinion
on the folly
of following Kaiser
Morphine instructions for this purpose.
"Morphine
suppresses the patient's drive to
breath and creates the
appearance of
inadequate breathing.
It also sedates the patient and
creates noisy breathing
as the tongue
relaxes back
in the throat.
To use morphine for the thus
medically created shortness
of breath
is LETHAL."
Statement
from Dr. Charles Phillips "Morphine
is a miracle drug to relieve pain,
very effectively in most
cases.
However if given inappropriately it is a loaded gun.
The following
information is
a recipe for MURDER!
Morphine is a deadly drug in
cases of COPD or emphysema and should not
be given
unless specifically
warranted for that patient if
ordered
by a physician or trusted nurse
that has
actually assessed the patient
in person. Oxygen is the preferred treatment for
shortness of
breath.
No
family should rely on such general instructions. Morphine
is like
a loaded gun
which is so powerful that can kill a
patient by lowering
their blood
pressure and stopping
the breathing." Further
Statements from Mr. Ron Panzer - President of Hospice
Patients Alliance Hospice
Staff Almost Never Use Narcan To Counteract Lethal Overdosages of
Narcotics
Death
from overdosage can be prevented Pain Crisis is Not Necessary if Narcan
is Titrated Hospice
Nurse Observes Illegal Euthanasia in Hospice
for
many other morphine related articles by Ron Panzer view:
http://www.google.com/search?q=morphine+site%3Awww.hospicepatients.org&sourceid=mozilla-search&start=0&start=
0&ie=utf-8&oe=utf-8&client=firefox-a&rls=org.mozilla:en-US:official
This page was created because of
concern for the
public's safety over
the following
Kaiser generated
article:
From a Kaiser Permanente leaflet
titled:
TO
OUR HOSPICE PATIENTS:
This
is
from the Section titled Emergency
Medication Kit: Contents:
Morphine solution 20mg/ml (30ml)
For
urgent management of shortness of breath
or difficulty in breathing:
*
Give 1/4 ml. of morphine solution into
the mouth or under the tongue every 4 hours
as needed.
If the
patient is already taking opiate pain
relievers (morphine, Dilaudid, fentanyl patch)
use lorazepam
tablets
instead. Give 1 tablet into the mouth or under the tongue
every
15
minutes until relieved or 3 doses are used.
The
onset of action and ease of breathing should
occur in 10-15 minutes and will persist
for 4 hours. The
patient may become sleepy. If the
patient must arise always provide
competent assistance as dizziness may
occur. CONCERNS
ABOUT TAKING MORPHINE Overdosing,
there is a good safety margin with
these medicines when given in the manner described.
Even a sizable
accidental over dosage usually
causes only sleepiness and unsteadiness.
Side
effects do occur, as with all medications.
|
Dr. Charles Phillips says that
morphine suppresses
the patient's drive
to breath and creates the appearance of inadequate breathing.
It
also sedates the patient and creates noisy breathing as the tongue
relaxes
back in the throat. To use morphine for the thus medically
created
shortness of breath is lethal. -
I
SUGGEST THAT ALL CAREGIVERS BECOME INFORMED
ABOUT ALL ASPECTS OF MEDICAL CARE THAT THEY ARE ASSISTING
WITH. PLEASE
LEARN WHAT AND WHY A MEDICINE IS BEING GIVEN BEFORE YOU ASSUME THE
RESPONSIBILITY
OF ADMINISTERING IT. NOT ALL OF US ARE DOCTORS AND NURSES. I
AM NOT
EITHER A DOCTOR OR A NURSE, BUT I WAS A CAREGIVER AND I DO KNOW THE
PAIN
OF FOLLOWING ADVICE THAT WAS INCORRECT FROM A MEDICAL PROFESSIONAL. I
AM
ALSO NOT GIVING MEDICAL ADVICE TO ANYONE. I AM MERELY
PROVIDING INFORMATION
THAT HAS BEEN PRESENTED TO ME FROM PERSONALLY TRUSTED
SOURCES. THIS
HAS ABSOLUTELY NOTHING TO DO WITH PAIN MANAGEMENT. THE
CONCERNS RAISED
IN THIS PAGE ARE ONLY ABOUT MORPHINE USE WITH BREATHING PROBLEMS.
MOST
OF US ARE SPOUSES AND CHILDREN OF THE
PATIENTS WHEN INVOLVED IN A KAISER HOSPICE SITUATION. WE
GENERALLY
ARE NOT MEDICAL EXPERTS AND WE NEED TO UNDERSTAND WHAT AND WHY WE ARE
DOING
CERTAIN THINGS. TO NOT DO SO MAY BRING US NEEDLESS REGRET IN
LATER
YEARS IF WE ARE LATER INFORMED THAT WE FOLLOWED
INSTRUCTIONS THAT WERE HARMFUL TO
OUR LOVED ONES. "Dosages of Lorazepam are usually
0.5 mg
for anxiety and may be 1
mg for most patients and they will be SNOWED for up to 8 to 16 hours if
they take that. If they are agitated,
only THEN would one increase the dosage. Agitated
does not mean slightly nervous, it means not acting in normal character
for the patient. The morphine
dosage should be in
milligrams (mg) NOT
IN ML because the
concentration of the liquid can be
changed.
If it is 20 mg per 2 cc, then giving 1/4 ml is not that bad and not a
problem.
The morphine dosage and giving it every four hours is ok, that is the
time
it lasts."-
Ron Panzer - President Hospice Patients Alliance
There is a lot of information on
the topic of
Morphine, both liquid
and intravenous and there are many sites that present both the pros and
the cons of this drug for breathing problems including Mercks Manual
and
the Physician Desktop Reference. None of them that I can
find, and
remember I am not a medical expert, are suggesting any form of morphine
in the size dose that Kaiser Hospice is recommending. All
that I
have read suggesting the use of morphine for breathing problems appear
to me, an untrained medical professional to be about a much smaller
amount
of morphine.  Hospice
Staff Almost Never Use Narcan To Counteract Lethal Overdosages of
Narcotics
Death from overdosage can be prevented
RESPIRATORY
DISTRESS AND OXYGEN Terminal
Agitation: A Major Distressful Symptom in the Dying
Sedated
to Death? When "comfort care" becomes dangerous
Visio-Baseline
Pulmonary Edema.vsd Contraindications to Morphine include severe COPD
and
respiratory distress Morphine
Overdose from Medline Morphine-like
opioids characteristically induce respiratory depression, hypotension,
nausea, vomiting, dizziness, sedation, mental clouding,
dysphoria,
pruritus, constipation, increased pressure in the biliary tract,
myoclonus,
and urinary retention. from the AMA - Report 4 of the Council
on
Scientific
Affairs (A-95) Full Text
Ventilator
Withdrawal of Patients with“Zero Capability” for
Respiratory Function by
Michael Harlos, MD Merck's
Manual on Respiratory Failure from Morphine
Merck's
Manual on Symptoms of the End of a Fatal Illness
Warnings
from RX on Morphine with chronic breathing problems
gastric
emptying, Obstructive airway disease, acute hepatic disease, MAO
Inhibitor
administration,
pregnancy,
lactation and in children. from Web Health Center
Morphine
Contraindicated in patients with respiratory depression in the absence
of resuscitative equipment
and
in patients with acute or severe bronchial asthma. Do not use in
patients
with chronic asthma, upper
airway
obstruction, or any other chronic pulmonary disorder without
considering
known risk of acute
respiratory
failure following morphine use in such patients. Respiratory depression
is the chief hazard
of
all morphine preparations and occurs most frequently in elderly and
debilitated
patients and those
suffering
from conditions accompanied by hypoxia or hypercapnia. Use extreme
caution
in patients with
decreased
respiratory reserve (eg, emphysema, severe obesity, kyphoscoliosis, or
paralysis of the
phrenic
nerve). Narcotics
(morphine): Clinical experience has suggested that severe dyspnea may
sometimes
be
relieved
by narcotics. These medications may have serious adverse effects and
clinical
studies
suggest
that the benefits may be limited to a few sensitive subjects. 102-106
There
is no advantage
of
inhalation as a route of administration.107-109
And
finally from Pain and Law
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